PracticeUpdate: Dermatology & Rheumatology

AMERICAN ACADEMY OF DERMATOLOGY 73RD ANNUAL MEETING 6

Dr Robert Brodell discusses wounds and ulcers, controversies inmanaging cutaneous lupus and dermatomyositis patients Robert Brodell MD, FAAD, is Professor and Chair of the Department of Dermatology at the University of Mississippi Medical Center in Jackson, and Editor-in-Chief of PracticeUpdate Dermatology .

AAD 2016 4–8 MARCH 2016 • WASHINGTON, USA PracticeUpdate

Dermatology ’s Editor- in-Chief and Editorial/ Advisory Board members weigh in on controversies in managing cutaneous lupus and

dermatomyositis patients, as well as treating and preventing herpes zoster; discussions on Zika-linked skin

SYM S056 – Wounds and ulcers: the good, the bad and the ugly. Robert S. Kirsner Eliot Mostow noted that the exact cost of wound care and the number of ulcers treated annually in the US needs further clarification. While 6.5 million chronic wounds at a cost of US$25 billion dollars per year have been a statistic cited multiple times, Dr Mostow proposes more focus on extrapolation from defined “closed healthcare” systems to flesh out these numbers more accurately and adjust for population changes. Multiple studies suggest that the costs may be higher even with (potentially) lower numbers of wounds. It is possible that the number exceeds that of non-melanoma skin cancers treated in a year. This is not a condition that dermatologists should cede to physicians from other specialties. Hadar Lev-Tov’s lecture stressed the importance of choosing the correct test to assess arterial insufficiency in patients with diabetic leg ulcerations. Transcuta- neous oxygenation measure and toe pressures can be a more accurate reflection of oxygenation and flow when compared withABI (ankle-brachial pressure index) because of collateral blood flow in the legs. Adam Friedman noted that he no longer uses silver sulfadiazine because the agent can impede wound healing. Silver dressings, however, are effective antimicrobials

eruptions; and insights on emerging technology in dermatology, from AAD 2016.

and improve healing rates when used appropriately. They are unlikely to cause argyria because of the small amount of silver actually used in the products. Manuka honey is helpful for wounds because of osmotic effects and by keeping the wound moist. However, honey that has not been irradiated (medical grade) may create risk for bacterial infections. Nitric oxide accelerates wound healing, but not all nitric oxide donors and generators perform equally. There are no products currently on the market harnessing this technology, but a number of promising studies suggest that new products will be available within a few years. FOC U067 – Controversies inmanagement and treatment of cutaneous lupus and dermatomyositis patients. Benjamin F. Chong When dermatomyositis (DM) is suspect- ed based on dermatologic signs, several

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